HomeMy WebLinkAboutBOH Final Minutes of April 28, 2021 with edit MINUTES - Draft
ORANGE COUNTY BOARD OF HEALTH
April 28, 2021
ORANGE COUNTY HEALTH DEPARTMENT MISSION STATEMENT: To enhance the quality
of life, promote the health, and preserve the environment for all people in the Orange County
community.
THE ORANGE COUNTY BOARD OF HEALTH MET ON April 28, 2021 virtually via Go To
Meeting.
BOARD OF HEALTH MEMBERS PRESENT: Sam Lasris — Chair, Bruce Baldwin —Vice-Chair,
Keith Bagby, Brian Crandell, Commissioner Jean Hamilton, Aparna Jonnal, Lee Pickett, Timothy
Smith and Alison Stuebe.
BOARD OF HEALTH MEMBERS ABSENT: Jessica Frega and Shielda Rodgers.
STAFF PRESENT: Quintana Stewart, Health Director; Rebecca Crawford, Financial and
Administrative Services Director; Victoria Hudson, Environmental Health Director; Carla Julian,
HIPAA Privacy and Security Officer, Compliance/Risk Manager; Dr. Monica Meng-Haggerty,
Dental Director; Ian Olson, Environmental Health Specialist; Kristin Prelipp, Communications
Manager; Beverly Scurry, BOH Strategic Plan Manager; and La Toya Strange, Administrative
Support I.
GUESTS PRESENT: None.
I. Welcome New Employees
There were no new employees in attendance.
II. Public Comment for Items NOT on Printed Agenda: None.
III. Approval of the April 28, 2021 Agenda
Motion was made by Alison Stuebe to approve the agenda, seconded by Bruce Baldwin
and carried without dissent.
IV. Action Items (Consent)
A. Minutes of March 24, 2021 Meeting
Motion was made by Lee Pickett to approve the minutes of March 2021 with an edit,
seconded by Brian Crandell and carried without dissent.
V. Educational Sessions
A. Criminal Justice Resource Department (CJRD) Diversion Program
Caitlin Fenhagen, Criminal Justice Resource Department Director, provided information about
CJRD, a department that oversees and supports jail alternatives programming in Orange
County. CJRD seeks to reduce the number of individuals with behavioral health issues in the
S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/
April Page 1
MINUTES - Draft
ORANGE COUNTY BOARD OF HEALTH
April 28, 2021
criminal justice system, to provide supportive services and to reduce the risk of recidivism.
Below are some highlights.
The CJRD programs include the:
• OC's Pretrial Release Program
o Has a goal of minimizing unnecessary detention by supervising individuals who are
likely to appear future court dates and do not pose a risk to the community as they
await trial.
• Adults Behavioral Health
o Has a goal of this position is to increase opportunities for pretrial release and
connection to community resources.
• Youth Mental Health Liaison
o Provides clinical services to youth ages 18 and under who are incarcerated, in
detention or at high risk in the criminal and juvenile justice systems.
• Recovery/Treatment Courts
o Two programs for court-involved adults who have substance use disorders.
■ Recovery Court is a diversionary court for individuals who are facing significant
terms of incarceration. Participants are referred to the program by judges,
defense attorneys, and probation officers.
■ Family Treatment Court is a collaborative effort between the court system and
the Department of Social Services (DSS). It is for parents who have a case
pending with DSS regarding abuse, neglect, or dependency.
• Restoration Legal Counsel
o Provide restorative legal services to low-income justice-involved individuals. This
legal assistance to qualified individuals includes driver's license restoration work,
expunctions, etc.
• Misdemeanor Pre-Arrest Diversion Program
o Diverts first-time arrests or citations of youth aged 16 or 17 for eligible misdemeanor
charges from the adult criminal justice system.
• Pre-Arrest Diversion Program
o Provides law enforcement the option to divert individuals 18 and older with no
criminal record on certain misdemeanor offenses.
• Local Reentry Council
o A network of community-based organizations and individuals that work together to
advocate for, support and connect the formerly incarcerated and justice involved with
necessary local services such as housing, employment, food, clothing, treatment,
transportation, etc.
• Street Outreach, Harm Reduction and Deflection (SOHRAD) Program
o Connects people living unsheltered with housing and services.
o Uses a trauma-informed, relationship-based model with visits to campsites,
hospitals, jails and the streets.
o Performs welfare checks, harm-reduction outreach, connections to housing and
services.
o Case management and peer support
o Accomplishments include
■ Has served over 130 people since October 2020
■ Over 20 law enforcement deflections
■ 22 people connected to emergency housing
■ 21 people exited to permanent housing
S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/
April Page 2
MINUTES - Draft
ORANGE COUNTY BOARD OF HEALTH
April 28, 2021
The BOH members had questions that were addressed by Ms. Fenhagen.
B. Formerly Incarcerated Transition (FIT) Program Update
Henry"Tommy" Green, Community Health Aide, gave an update on the FIT program. He began
by defining the FIT program and its purpose. Below are some highlights:
• FIT program was designed to connect formerly incarcerated people with a chronic
condition to health care services via the help of a community health worker (CHW).
• Other community re-entry resources are available to help with a comprehensive re-entry
plan. The FIT program works with its partners and assists clients with finding housing,
employment and getting into substance abuse programs.
• Currently, Orange, Durham, Wake, Mecklenburg and Guilford counties have FIT
programs.
• Some of the data provided included:
o Serious mental illness is 2 to 4 times higher in state prisons than in the community.
o Out of a study of 1,100 people exiting imprisonment, 80% of men and 90% of
women had a chronic disease that required management including heart disease,
diabetes, HIV, Hepatitis C, and dementia.
o Current caseload is 73 clients of which 40 are active cases. The OC FIT recidivism
rate is almost 14% as opposed to the state average of 40%.
o A high number of clients suffer from substance use disorder (SUD). This population
has a high level of overdose within 2 weeks of release from incarceration. Currently,
there are 10 Medical Assistant Treatment (MAT) clients. Studies have shown that
MAT decreases the risk of overdose by 60%.
o One of the DIPS responses to the COVID pandemic was the Extended Leave of
Confinement (ELC) program, which released some prisoners early that were
considered high risk for COVID exposure. Even though they were released, they
were still considered prisoners which disqualified them for certain state benefits,
some health care services, and the FIT program. NC FIT's response was FIT
Connect. Launched in April 2020, its focus was to connect the ELC prisoners to
health care services. There were 1100 referrals received from the state prison
system of which approximately 800 were connected to health care services.
o The FIT Program was selected as the technical assistance manager for an $11
million investment grant from NC DHHS that will focus on reentry and pre-arrest
diversion for people with SLID and mental illness. FIT will work with the awardees,
including the CJRD, to manage this grant.
C. 31 Quarter Financial Reports & Billing Dashboard
Rebecca Crawford, Financial &Administrative Services Director, gave a report on the 3rd
quarter revenue and billing accuracy. Her report is as follows:
• Total Health Department Budget vs. Actuals:
Average YTD monthly revenue in FY20-21 after the third quarter is $304k/month or
$2.7M YTD, representing 65% of our overall budgeted revenue for the year. As usual
though, the total third quarter revenue is skewed down due to the majority of state funds
not eligible to be drawn in July (this is typical) and allocations of Medicaid Max funds will
not be transferred into our budget until the end of the fiscal year. Revenues are higher
than this point last fiscal year due to state allocations for the COVID-19 pandemic
S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/
April Page 3
MINUTES - Draft
ORANGE COUNTY BOARD OF HEALTH
April 28, 2021
response and increased revenue for Environmental Health and Dental (FY 19-20 third
quarter YTD: $2M). Expenses are in line with revenues, at 61.3% of the overall budget.
• Dental Earned Revenue by Source:
The FY 20-21 average monthly revenue ($35k/month) for the third quarter is below our
budget projection ($41 k/month) and our FY 19-20 average of$39.7k/month due to
longer than anticipated dental clinic closures during the pandemic and the Dental
Division Director vacancy in the first quarter. PPE shortages had a negative impact on
the dental clinic and its ability to re-open to increased capacity, as Dental staff are
required to wear a higher level of PPE for most procedures; however, that has improved
over the past quarter. The clinic is now adding additional appointment times and days to
be open, which have allowed staff to see more patients. FY 20-21 dental earned
revenue totaled $315k at the end of the third quarter compared $445k at the end of the
FY 19-20 third quarter.
• Medical Earned Revenue by Source:
Medical earned revenue is currently above the budgeted projection for FY 20-21
($33k/month) at $39.9k/month due to greater than anticipated revenue during the
pandemic. Telehealth visits have been very successful and allowed the clinic to continue
to see patients and bill for services even as in-person visits were limited. Billing staff
have also worked diligently to collect as much revenue as possible from Medicaid and
insurance companies from older accounts. We anticipate this trend toward increased
revenue will continue to improve as the medical clinic gradually adds more in-person
visits based on PPE availability and staff capacity. Medical clinic revenue totals $359k
for third quarter FY 20-21 compared to $378k in third quarter FY 19-20.
• Environmental Health Earned Revenue by Source:
Environmental Health earned revenue is slightly below the budgeted projection for FY
20-21 ($53k/month) at $47.3k/month. We are starting to see our seasonal trend of
increase revenue in the third quarter of the year due to spring pool inspections and
better weather for outdoor inspections and site visits. EH staff have worked hard to
continue OSWP inspections during the pandemic with little to no in-person required of
residents. FY 20-21 third quarter YTD revenue ($426k) is higher compared to third
quarter YTD FY 19-20 ($401 k).
• Grants Fund Revenue:
FSA has drawn $200k of the multi-year Kenan grant. Expenditures are tracking as
anticipated but we will most likely not fully expend the Kenan grant and thus will not
request reimbursement for the full grant amount as many FSA staff have been re-
deployed for the COVID-19 pandemic response.
D. Advisory Board Update
Beverly Scurry, Board of Health Strategic Plan Manager, made reference to the Advisory Report
sent to the Board in advance of the meeting and stated that COVID-19 related issues were a
topic of discussion for most boards. She asked the Board if there were any questions. The
Board had none.
E. Gaines Chapel Road (GCR) Study
Kojo Minta, a UNCG graduate student, presented a study on the Gaines Chapel community.
S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/
April Page 4
MINUTES - Draft
ORANGE COUNTY BOARD OF HEALTH
April 28, 2021
Below are some highlights of the study.
• Brief background of the community
■ The community is located between two highways — US Route 70 & Interstate 40.
■ Most of the residential homes are lived in by people of color and are economically
marginalized which may cause a potential issue for paying for Orange-Alamance
sewer.
■ Most residents are on Orange-Alamance water but not given the opportunity to be on
Orange-Alamance sewer. This disparity can present itself as a form of
environmental injustice.
■ Other disparaging factors include:
o There is poor soil quality that affects communities specifically below the railroad
track.
o The potential lack of education provided about properly abandoning well and
managing septic systems for the low-income residents.
• Some of the outcomes were to affect the needs for sewer service, to determine financial
barriers related to access to food, to empower residents to maintain septic tanks, and to
properly abandon wells.
• The goals and objectives of the study
■ Determine need for sewer lines through community.
o Create a logic model of the current sewage resources and barriers.
o Review policies that contribute to environmental injustice.
o Collect qualitative data from GCR septic tank-owners.
■ Identify wells that need to be properly abandoned.
o Collect qualitative data from GCR properties.
• Data Collection
■ Mr. Minta, with the assistance of an on-site water protection specialist, conducted
door-to-door surveys in the GCR community with binary and open-ended questions.
Property records were updated with information such as the current homeowner and
the number of residents in the home. Any system conditions were also recorded.
■ Questionnaires were mailed to unavailable respondents.
• Analysis
■ There were 18 residents that were contacted during the door-to-door survey. Of
those residents:
0 13 of them expressed interest in municipal sewer service.
o '/2 of them stated that there was an economic barrier.
o There were a couple of residents who wanted to remain on their septic even if
offered municipal sewer service from Orange-Alamance utility.
0 33% of those residents did not know the last time they pumped their tank.
o There were a couple of wells improperly abandoned or not abandoned at all,
even at residences that were connected to Orange-Alamance water.
• Relevant Policies included:
■ Orange County Sewer Rate Structure (2016)
$13.39 as base; 2,000-gallon minimum per month
• Recommendations
■ Base rate of$13.12; 2,000-gallon minimum per month.
■ Collaborate with community organizations for education outreach.
■ Financial assistance disseminated to low-income stakeholders.
• Outcomes of program strategies
■ Address improperly abandoned wells to reduce environmental health risks.
S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/
April Page 5
MINUTES - Draft
ORANGE COUNTY BOARD OF HEALTH
April 28, 2021
■ Make sewer service equitable for low-income residents.
■ Empower GC through community partnership and health education.
The BOH members had questions that were addressed by Mr. Minta, Commissioner
Hamilton and Victoria Hudson.
VI. Reports and Discussion with Possible Action
A. Health Director Report
In addition to her report, some of items Ms. Stewart briefly highlighted are below.
• Ms. Stewart spoke about the April 9t" virtual Town of Chapel Hill EOC Appreciation
Celebration. Secretary Mandy Cohen attended acknowledging the OCHD team, the
community partners, members and volunteers for our COVID response.
• Ms. Stewart attended the Health Director Legal Conference where she also presented
as a panelist on day 2 for a session titled "Lessons from the Field: Working with a Local
University". The conference was held in half-day segments over a 3-day period.
• The Family Success Alliance (FSA) received an award from the OC Housing &
Community Development recognizing their assistance over the last year with the
Emergency Housing Assistance (EHA) program. In 2020, the HOPE program and the
EHA program served 1,245 households and provided over$4 million in financial
assistance, which helped prevent evictions and homelessness to many of the residents
in our community.
• In May, it is planned that the NCALHD's Executive Committee will be held in person.
There are also plans for June's Full Association meeting to be held in person.
• OCHD personnel updates:
o We're still recruiting for the Personal Health Services Director. The 1st round of
interviews were completed; however, there weren't any viable candidates. The
position will be reposted as this is a key leadership position and tough to fill.
o The Medical Clinic's clinic manager position has been reposted as interviews were
conducted but there weren't any viable candidates.
o Medical Clinic staff are still positive and very motivated. Retention for the clinics has
steadied. Clinic is a little down not just because of the vacancies but because some
of them were pulled to assist with COVID tasks. We're in the process of
determining how to slowly transition them back to their primary duties while also
tackling COVID tasks.
B. COVID-19 Update
Quintana Stewart, Health Director, gave an update on the COVID-19 status in Orange County
(OC) as well as took questions from the Board. Some highlights are below.
• As of today,
■ In OC, there are 8,451 confirmed cases and 101 deaths in related to COVID. The
percent positive is 1.1%.
■ There is one outbreak at a residential facility in OC.
• Vaccinations—
■ In OC, 46.8% have received their 1st dose and 40% are fully vaccinated.
S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/
April Page 6
MINUTES - Draft
ORANGE COUNTY BOARD OF HEALTH
April 28, 2021
■ Supply outweighs demand. We're being creative and innovative while working with
community partners to determine what are the barriers are for those that want the
vaccine.
■ On April 15th, the 10,000th shot was given.
■ The state has changed the process for allocation. We have an ordering process.
The order needs to be placed each Wednesday, by 12 noon, if we want to receive
more vaccines. The requirement is that we must use 50% of the last order received
before ordering more.
• Vaccination clinics are now held on consistent days at the Whitted location in the BOCC
Conference Room. There are two morning and two evening clinics. The times are:
■ Mondays from 2-7p; Wednesdays from 8a-1 p; Thursdays from 2-7p; Fridays from
8a-1 pm
• We continue to have pop-up sites and are working with community partners to find
where they are needed. They occur mostly on Saturdays.
• The OCHD performed outreach to our homeless/unsheltered population and vaccinated
them using the Moderna and Pfizer vaccines verses waiting for the one-dose J & J
vaccine to become available again.
• The OCHD continues to serve homebound OC residents. They can call the Call Center
and inform them that they need vaccination. Our mobile team will vaccinate them in their
home.
• Being mindful of our human resources, the OCHD tries to make people aware of the
vaccination site closest to them.
• Tomorrow is the last day at the UNC RR Lot. We're transitioning from the UNC RR Lot
for the big mass vaccinations as we no longer have the demand to justify use of that
space, cost of tents, volunteers, etc. The weather also poses a safety concern as there
is no quick way of getting shelter if thunderstorms appear.
• Friday at 5pm, the Governor's Executive Order 209 takes effect.
o Lifted the requirement for face covering outdoors as research has shown little
transmission in outdoor spaces. Face coverings are still recommended if you're
going to be in a very crowded outdoor setting.
o Business capacities remain the same.
o Mass gathering limits also increase.
■ 50 to 100 people indoors
■ 100 to 200 people outdoors
o If two-thirds of the state population have received at least their 1 st vaccine, after
looking at science and data, the Governor will consider lifting the face covering
mandate entirely.
C. Media Items
Kristin Prelipp, Communications Manager, mentioned that the articles in the Board packet were
just a selection of the numerous COVID-19-related articles that were gathered. Included in the
Board's packet were an article from the Chapelboro regarding OC's efforts to equitably
vaccinate minorities, a CBS17 article regarding OC reporting the highest percentage of partially
and fully vaccinated residents, and an article from News of Orange County announcing that
OCHD administered its 10,00011 first dose of the COVID vaccine.
Media items were in the packet which focused on Orange County's events and our
involvement in various efforts.
S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/
April Page 7
MINUTES - Draft
ORANGE COUNTY BOARD OF HEALTH
April 28, 2021
D. BOH In-person Meetings
In the interest of time, Board Chair, Sam Lasris, stated that this topic would be discussed at the
next meeting.
VII. Board Comments
Bruce Baldwin mentioned that, last Thursday, Ms. Stewart presented the BOH Workplan
to the BOCC, who were very impressed with all that OCHD accomplishes. He also
congratulated Victoria Hudson on receiving her award.
Vill. Adjournment
Brian Crandell moved to adjourn the meeting at 9:00pm and Bruce Baldwin seconded.
The next Board of Health Meeting will be held May 26, 2021 at 7:00pm via Go To Meeting.
Respectfully submitted,
Quintana Stewart, MPA
Orange County Health Director
Secretary to the Board
S:\Managers Working Files\BOH\Agenda &Abstracts\2021 Agenda &Abstracts/
April Page 8